Anal Fissures and Haemorrhoids Flashcards
(6 cards)
What is an anal fissure?
Tear or ulcer in anal canal causing bleeding or pain on defecation
What is the acute management of anal fissure?
Make the stool easier to pass and help with pain
- Bulk-forming laxatives or osmotic laxative
- analgesia or local anaesthetic (lidocaine)
What is the chronic management of anal fissures?
6 weeks +
- GNT rectal
- topical or oral diltiazem or nifedipine
What are haemorrhoids?
Swelling of vascular mucosal anal cushions around the anus
- very high risk in pregnancy
How are haemorrhoids managed?
Maintain soft stools to minimise straining when passing
- increase fibre and fluid + bulk forming forming laxative
- paracetamol for pain
- Itching/ pain: topical anaesthetics (lidocaine) or topical corticosteroids (7 days max)
why is only paracetamol used in haemorrhoid pain
- why not ibuprofen or codeine?
Ibuprofen = exacerbate rectal bleeding
Opioids = constipation
